Individual provider Active NPI

Kim Phyllis Roper, PTA

  • Physical Therapy Assistant
  • St Petersburg, FL
National Provider Identifier
1699049023
Registry record updated Mar 2, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
225200000X Issued in FL
Practice address
6315 2ND Ave N
St Petersburg, FL 33710-8419
Phone
(727) 365-9870
NPI assigned
Mar 2, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 2, 2012

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X 225200000X FL Primary

Addresses

Primary practice location

6315 2ND Ave N
St Petersburg, FL 33710-8419

Mailing address

6315 2ND Ave N
St Petersburg, FL 33710
Phone (727) 365-9870

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
225200000XFLMDPhysical Therapy Assistant

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1330646400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1330646400000",
    "number": "1699049023",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6315 2ND AVE N",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "33710",
            "telephone_number": "727-365-9870"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6315 2ND AVE N",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337108419",
            "telephone_number": "727-365-9870"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROPER",
        "first_name": "KIM",
        "middle_name": "PHYLLIS",
        "name_prefix": "Mrs.",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-03-02",
        "last_updated": "2012-03-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "FL",
            "license": "225200000X",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in St Petersburg, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 2, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.